Our library of drug research abstracts drawn from the medical literature is updated on a regular schedule, and you can be assured that new metrogel research articles will be listed here shortly after becoming available to us.
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Medical research on metrogel
World J Gastroenterol. 2008 Jun 28; 14(24): 3855-60
Ching SS, Sabanathan S, Jenkinson LR
AIM: To compare a lansoprazole-based triple versus quadruple therapy for Helicobacter pylori (H pylori) eradication with emphasis on side effect profile, patient compliance and eradication rate at a rural district general hospital in Wales, United Kingdom. METHODS: One hundred one patients with H pylori infection were included in the study. Patients were randomised to receive triple therapy comprising of lansoprazole 30 mg, amoxycillin 1 g, clarithromycin 500 mg, all b.d. (LAC), or quadruple therapy comprising of lansoprazole 30 mg b.d., metronidazole 500 mg t.d.s., bismuth subcitrate 240 mg b.d., and tetracycline chloride 500 mg q.d.s. (LMBT). Cure was defined as a negative (13)C urea breath test 2 mo after treatment. RESULTS: Seven patients were withdrawn after randomisation. Fifty patients were assigned to LAC group and 44 to LMBT group. The intention-to-treat cure rates were 92% and 91%, whereas the per-protocol cure rates were 92% and 97%, respectively. Side effects were common, with 56% experiencing moderate to severe symptoms in the LAC group and 59% in the LMBT group. Symptoms of vomiting, diarrhoea and black stools were significantly more common in the LMBT group. Patient compliance was 100% for triple therapy and 86% for quadruple therapy (P < 0.01). One-third of patients in both groups were still taking acid-reducing medications at six-month follow-up. CONCLUSION: One-week triple and quadruple therapies have similar intention-to-treat eradication rates. Certain side effects are more common with quadruple therapy, which can compromise patient compliance. Patient education or modifications to the regimen are alternative options to improve compliance of the quadruple regimen.
Scand J Infect Dis. 2008 Apr 7; 1-7
Mattila E, Anttila VJ, Broas M, Marttila H, Poukka P, Kuusisto K, Pusa L, Sammalkorpi K, Dabek J, Koivurova OP, Vahatalo M, Moilanen V, Widenius T
A prospective, randomized, double-blind study was designed to compare Clostridium difficile immune whey (CDIW) with metronidazole for treatment of laboratory-confirmed, recurrent, mild to moderate episodes of Clostridium difficile-associated diarrhoea (CDAD). CDIW was manufactured by immunization of cows in their gestation period with inactivated C. difficile vaccine. The resulting colostrum was processed, immunoglubulins were concentrated and the end-product containing high titres of C. difficile immunoglobulin was used as CDIW. 20 patients received metronidazole at a dosage of 400 mg t.i.d. and 18 patients CDIW 200 ml t.i.d. The study was interrupted early because of the bankruptcy of the sponsor. After 14 d of treatment, all 20 (100%) of 20 patients had responded to metronidazole therapy, compared with 16 (89%) of 18 who had received CDIW. 70 d after the beginning of treatment, sustained responses were observed in 11 (55%) of 20 patients receiving metronidazole and 10 (56%) of 18 patients treated with CDIW. In this preliminary study CDIW was as effective as metronidazole in the prevention of CDAD recurrences and it was well tolerated.
J Dermatolog Treat. 2008 Apr 23; 1-7
Jayawant SS, Feldman SR, Camacho FT, Yentzer B, Balkrishnan R
Background: Refill adherence to medications and healthcare costs are important factors to consider while making informed decisions regarding the treatment of rosacea patients. Objective: The objective of this study was to examine predictors of number of refills related to topical metronidazole and total healthcare costs in rosacea patients. Methods: This study utilized a longitudinal cohort design and followed rosacea patients enrolled in North Carolina Medicaid and who were prescribed at least one study medication (topical metronidazole, adapalene, azelaic acid, permethrin, and sulfacetamide). Patients' demographic characteristics, number of metronidazole refills, and different components of healthcare costs were examined. Results: Out of the total 2587 rosacea patients, the majority ( approximately 69%, n = 1771) had one or more prescriptions for topical metronidazole. Most of the patients in this study were white (73%). After controlling for other variables, increasing age was associated with a higher number of metronidazole refills and healthcare costs (both p
J Antimicrob Chemother. 2008 Jul 7;
O'Connor R, Baines SD, Freeman J, Wilcox MH
Objectives Clostridium difficile infection is a nosocomial disease of increasing importance. First-line treatment is limited to metronidazole or vancomycin. Oritavancin is a lipoglycopeptide with activity against Gram-positive bacteria, including drug-resistant pathogens. MICs of oritavancin, metronidazole and vancomycin for genotypically distinct C. difficile strains, including epidemic C. difficile PCR ribotypes 001 and 027, were determined by agar incorporation and broth macrodilution methods. In agar incorporation methods, the impact of supplements on oritavancin MICs was tested to address oritavancin binding to surfaces. Methods Thirty-three genotypically distinct C. difficile strains were identified by PCR ribotyping. Wilkins Chalgren agar incorporation plates containing oritavancin, metronidazole and vancomycin were prepared with and without 0.002% polysorbate-80 (P80) and lysed horse blood (2%). Broth macrodilution MICs of oritavancin, metronidazole and vancomycin were determined in Brucella broth. Inoculated agar incorporation plates and broth macrodilution tubes were cultured anaerobically at 37 degrees C for 48 h. Results Broth macrodilution MICs were lower than agar incorporation MICs for oritavancin, but not for metronidazole and vancomycin. Oritavancin broth macrodilution MIC(90)s were 2- to 4-fold lower than the corresponding agar incorporation MIC(90)s, while geometric mean MICs were >5-fold lower. Oritavancin broth macrodilution MIC(90)s were approximately 2- and 5-fold lower than those for metronidazole and vancomycin. Metronidazole was the most active antimicrobial agent against C. difficile using agar incorporation methods. Oritavancin agar incorporation MIC(90)s were unaffected by 0.002% P80 and/or 2% lysed horse blood. Conclusions Oritavancin was at least 4-fold more potent than vancomycin against the majority (25/33) of C. difficile strains tested by broth macrodilution. Oritavancin activity may be underestimated by agar incorporation methods, regardless of the use of P80 or lysed horse blood.
Kathmandu Univ Med J (KUMJ). 2007 Jul-Sep; 5(3): 378-81
Joshi S, Agarwal B, Malla G, Karmacharya B
Aim: To analyse demography, clinical presentation, treatment, complications and outcome of patients with tetanus over a 2-year period. Materials and methods: A retrospective analysis of medical records of all patients with tetanus admitted to the intensive care unit of B.P Koirala Institute of Health Sciences, Dharan, Nepal between July 2004 and June 2006. Results: Tetanus accounted for 1.1 % of our ICU admission. Eight tetanus patients (mean age 52 years; M: F ratio 7:1) were admitted. The tetanus prone wounds of seven patients were managed at home. The most common presenting complaints were trismus and stiffness of neck and back (87.5%). Elective intubation was followed by tracheostomy in all the patients. Overall mean duration of ventilatory support was 12.5 days. Treatments given in ICU were diazepam, magnesium sulphate, tetanus immunoglobulin, metronidazole, wound management and supportive measures. Five patients (62.5%) developed autonomic instability and three patients had ventilatory associated pneumonia (37.5%). Average ICU stay was 15.1 days while hospital stay was 20.1 days. Five patients (62.5%) survived the course of disease. Two patients (25%) left the hospital against medical advice while the other (12.5%) died in ICU. Conclusion: Tetanus is a vaccine preventable disease. Tetanus prone wounds should be managed appropriately. Respiratory compromise and autonomic instability are the main causes of morbidity and mortality. Early recognition, intense support and prompt treatment improves morbidity and mortality of patients diagnosed with tetanus.
Efficacy and tolerance of metronidazole and miconazole nitrate in treatment of vaginitis.
Int J Gynaecol Obstet. 2008 Jul 4;
Peixoto F, Camargos A, Duarte G, Linhares I, Bahamondes L, Petracco A
OBJECTIVE: To evaluate the efficacy and tolerability of a vaginal pessary containing 750 mg of metronidazole and 200 mg of miconazole nitrate used daily for 7 days in the treatment of vaginitis. METHODS: Ninety-two women with vaginitis participated in this phase 3 study using one vaginal pessary daily for 7 days. Gynecological and microbiological evaluations were carried out prior to and following treatment. RESULTS: Reductions occurred in symptoms and signs of vaginitis. Clinical cure rate was 87.7%, while the cure rates according to microscopy and Candida albicans culture were 81.8% and 73.9%, respectively. The cure rate for bacterial vaginosis was 75% and culture of Gardnerella vaginalis turned negative in 63.6% of cases following treatment. The medication was well tolerated. CONCLUSION: Use of a combination of 750 mg of metronidazole and 200 mg of miconazole in a single daily application was found to be effective in the treatment of the most common causes of vaginitis.
J Gastroenterol. 2008; 43(6): 429-33
Usta Y, Saltik-Temizel IN, Demir H, Uslu N, Ozen H, Gurakan F, Yuce A
BACKGROUND: Research regarding the optimal therapeutic approach to Helicobacter pylori infection in children is ongoing. There is no consensus as to duration of treatment or second-line therapy. The purpose of this study was compare the efficacy of 7-day and 14-day triple therapies and report the results of second-line quadruple therapy in children. METHODS: A total of 275 consecutive H. pylori-infected patients were enrolled into two groups. Group 1 (n = 180) received triple therapy with 14 days of amoxicillin and clarithromycin and 21 days of proton pump inhibitor. Group 2 (n = 95) received triple therapy including 7 days of amoxicillin and clarithromycin with 21 days of proton pump inhibitor. Subsequently, 89 patients not responding to the triple therapies received quadruple therapy comprising omeprazole (14 days), bismuth subcitrate (7 days), doxycycline (7 days), and metronidazole (7 days). Eradication was evaluated by (13)C-urea breath test. RESULTS: The per-protocol eradication rates in groups 1 and 2 were 60.5% and 55.8%, respectively (P = 0.44). In the second interview with 227 patients, severe symptoms were reported to have disappeared in 59% and decreased notably in 34.8%. Helicobacter pylori was eradicated in 66.7% of patients at the end of the quadruple therapy. In the third interview with 75 patients, severe symptoms had decreased in 38.6% and disappeared in 56%. CONCLUSIONS: The different duration of the two treatment regimens had no impact on eradication rates. Furthermore, quadruple therapy was necessary to achieve H. pylori eradication after triple therapy. However, the eradication rate with quadruple therapy was still insuf-ficient. Consequently, a new therapeutic approach to H. pylori infection in children is needed.
Ann Intern Med. 2008 Jul 1; 149(1): 20-8
Marrazzo JM, Thomas KK, Fiedler TL, Ringwood K, Fredricks DN
BACKGROUND: Bacterial vaginosis frequently persists after treatment. The role of newly defined bacterial vaginosis-associated bacteria (BVAB), which have a specificity for this condition of 97% or greater, has not been assessed. OBJECTIVE: To define risks for bacterial vaginosis persistence, including pretreatment detection of specific vaginal bacteria, among women reporting sex with women. DESIGN: Observational cohort study. SETTING: University-based research clinic. PATIENTS: 335 women age 16 to 29 years reporting sex with at least 1 woman in the past year. Participants were recruited through advertisements and provider referral. INTERVENTION: Bacterial vaginosis was treated with intravaginal metronidazole gel (0.75%), 37.5 mg nightly for 5 nights. MEASUREMENTS: Species-specific 16S recombinant DNA polymerase chain reaction assays targeting 17 bacterial species were applied to vaginal fluid obtained at baseline. Test of cure by clinical criteria and Gram stain analysis and repeated polymerase chain reaction assays of vaginal fluid were performed 1 month after treatment, and interim behaviors were assessed by using computer-assisted self-interview. RESULTS: Of 335 women, 24% of whom also reported sex with men within 3 months before enrollment, 131 (39%) had bacterial vaginosis. In the 120 (92%) women who returned for follow-up, the incidence of persistent bacterial vaginosis was 26% and was statistically significantly higher in women with baseline detection of 3 Clostridiales bacteria, designated as BVAB1 (risk ratio, 2.0 [95% CI, 1.1 to 4.0]), BVAB2 (risk ratio, 8.7 [CI, 2.5 to infinity]), or BVAB3 (risk ratio, 3.1 [CI, 1.7 to 5.8]); Peptoniphilus lacrimalis (risk ratio, 3.5 [CI, 1.6 to 15.5]); and Megasphaera phylotype 2 (risk ratio, 3.4 [CI, 1.4 to 5.5]). Persistence was lower with treatment adherence (risk ratio, 0.4 [0.2 to 0.9]). Detection of these bacteria at the test-of-cure visit was associated with persistence, whereas posttreatment sexual activity was not. LIMITATIONS: Findings may not be generalizable to women who have sex only with men, or to women whose bacterial vaginosis is treated with oral antibiotics. The study may be too small and may involve a population that is too highly selected to draw definitive conclusions about associations of persistent infection with posttreatment sexual behaviors. CONCLUSION: Persistent bacterial vaginosis is associated with several bacteria in the Clostridiales order, Megasphaera phylotype 2, and P. lacrimalis, suggesting that vaginal microbiology at diagnosis may determine risk for antibiotic failure.
Ann Intern Med. 2008 Jul 1; 149(1): I30
Lowering of 5-nitroimidazole's mutagenicity: Towards optimal antiparasitic pharmacophore.
Eur J Med Chem. 2008 May 27;
Crozet MD, Botta C, Gasquet M, Curti C, Rémusat V, Hutter S, Chapelle O, Azas N, De Méo M, Vanelle P
To improve the antiparasitic pharmacophore, 20 5-nitroimidazoles bearing an arylsulfonylmethyl group were prepared from commercial imidazoles. The antiparasitic activity of these molecules was assessed against Trichomonas vaginalis, the in vitro cytotoxicity was evaluated on human monocytes and the mutagenicity was determined by the Salmonella mutagenicity assay. All IC(50) on T. vaginalis were below the one of metronidazole. The determination of the specificity indexes (SIs), defined as the ratios of the cytotoxic activity and the antitrichomonas activity, indicated that 11 derivatives had a SI over the one of metronidazole. Molecules, bearing an additional methyl group on the 2-position, showed a lower mutagenicity than metronidazole. Moreover, three derivatives were characterized by a low mutagenicity and an efficient antitrichomonas activity.